Definition: Torticollis or Wryneck

Torticollis - Wryneck is a form of Cervical Dystonia, where a person's head and neck are twisted by spasms in their neck muscles, which contract down towards one side all the time, often with abnormal rigidity. Torticollis may develop gradually or suddenly and babies may be born with Congenital Muscular Torticollis.

Acute Torticollis or Wryneck is the term given when the condition arrives suddenly, in which case the person may wake up to find they have slept in a distorted position and they have such a stiff neck that they cannot move their head from side to side. This problem often resolves itself fairly quickly but a wise person would ask themselves what they might have been doing to bring it on and then find a way of avoiding it happening again.

Diagnosis

When severe, torticollis may be associated with damage to the cervical vertebrae and discs. Diagnosis is essential when there are symptoms such as chronic neck pain with numbness in the hands and arms. This numbness not only poses a threat to many careers but indicates an underlying problem where the nerves are being irritated and the cause needs to be known, to check for a prolapsed disc and to rule out problems such as meningitis or other illness, particularly if the person also has a fever.

Causes

Torticollis can be caused by accidents, injuries, tissues scarring and shrinkage, plus can be brought about by mental states such as anxiety.

Habitual movement patterns with poor posture and long-term mis-use of the body that disturbs the natural muscle balance in the neck, such as curling down and twisting over whilst handwriting can lead to the gradual development of torticollis. Unfortunately it is all too frequent to see children hunched over their school books, holding the pen in a contracted, twisted manner whilst writing and this is a habit that they will probably take into adulthood, unless they learn to let go of it. Also babies whose heads are left lolling down to one side as they sleep in pushchairs, must be vulnerable to wryneck developing. Over time the neck muscles can get used to being contracted in this way and they become fixed so that torticollis can develop.

There are also work situations which require a person to incline their head and possibly their body in one direction constantly. Radiologists for instance, or violinists, often resort to pulling their heads down to one side quite tensely in order to work or hold the violin in place. Dentists often lean down over patients at an angle and twist to look into their mouths - and they do this for hours on end all their working lives. If these activities are performed without due thought as to how to look after the head-neck-back relationship and general body use, then problems such as torticollis are likely to develop.

Treatment

In extreme cases, botulism can be injected into the muscle to stop the spasm for a few months and surgery to partially cut and release the contracted muscle is sometimes resorted to. Physiotherapy to help stretch out the muscles can be helpful.

Fortunately, it is possible to improve one's body use by learning the Alexander Technique and in this way stopping habits of twisting and contracting that contribute to the torticollis. Through the gentle guidance of the Alexander Teacher, it is possible to re-educate the muscles so that they can relax and ease out of the neck spasm, therefore putting less pressure onto vulnerable discs and nerves and re-establishing the natural head neck and back relationship.

Many violinists for instance have been saved from constant pain which could threaten their careers, by applying the Alexander Technique to playing the violin, so that they can hold and use their instrument in a manner which does not cause them harm. They also learn to maintain the freedom and resilient lengthening of their muscles, so that they do not go into spasm as a result of playing and holding the violin.

Related to this, a major research study, the ATLAS Research Trial (2015) has shown that the Alexander Technique produced "clinically relevant reductions in neck pain and associated disability" for people with chronic non-specific neck pain.